Black Death, White Medicine: Bubonic Plague and the Politics of Public Health in Colonial Senegal, 1914-1945 (review)

In writing about the Salem witch trials, historians Paul Boyer and Stephen Nissenbaum observed that the trials were like a lightning strike in the night, better illuminating the terrain for the passing stranger (Salem Possessed, 1974). Myron Echenberg's extended analysis of bubonic plague outbreaks in colonial Senegal during the first half of the twentieth century clearly demonstrates that episodes of epidemic disease can serve the same function. His examination of the plague episodes illuminates the local political and social realities of colonial Senegalese society. Since the 1970s, historians of Africa interested in the history of disease have argued that looking at disease not only adds a new dimension to African history, but also deepens our understanding of the social, economic, and political processes that have shaped African history; few studies have demonstrated the truth of this assertion as well as Black Death, White Medicine.

For those familiar with the general outlines of Senegalese colonial history, and particularly the early political history of the four communes—Dakar, St. Louis, Goree, and Rufisque—Echenberg's study of plague is particularly revealing. Outbreaks of plague, colonial efforts to combat it, and African responses to both plague and colonial medical interventions, were closely linked to local struggles over African political rights and the political rise of the Senegalese politician Blaise Diagne. Echenberg in fact demonstrates that the political crisis created by Diagne's election to Parliament in 1914, and the public health crisis created by the arrival of plague in that same year, need to be viewed together in order for either event to be fully understood.

Echenberg's discussion of colonial responses to plague also reveals the extent and depth of racial discrimination in French colonial Africa. While the political rights enjoyed by the African inhabitants of the four communes may have prevented the French from applying the more extreme forms of sanitary segregation experienced elsewhere in colonial Africa, Echenberg provides multiple examples of how plague measures were instituted differentially on the basis of race. For example, Africans, regardless of class, were required to carry proof of vaccination in order to move freely about the colony during the plague years; Europeans, who may have been just as likely to spread the plague, were exempted from this requirement. Colonial officials routinely employed coercive methods to burn infected African dwellings and isolate suspected African cases in lazarettos; Europeans were again exempted from such procedures. Not surprisingly, ideas of equality and assimilation were quickly forgotten when European lives were threatened by plague.

Black Death, White Medicine also contributes to our understanding of how Africans experienced and responded to both plague and colonial medical interventions. In this regard, it helps fill a significant void in the history of disease and medicine in Africa. We know a lot more about colonial constructions of disease than about African understandings of disease. Echenberg draws on a combination of ethnographic materials and oral testimonies to show how both urban and rural Africans experienced plague outbreaks and the colonial responses to them. Though his effort to employ recent ethnographic material to define past beliefs and practices raises some difficult methodological questions, his use of personal testimonies provides some powerful images of what plague was like for local Africans.

Finally, Echenberg makes an effort to explain the epidemiologic history of plague, describing both the physical and social environment in which plague occurred. Students of disease history will find this useful, but also frustrating. The study raises many questions concerning why plague spread in different ways at different...